Panels Vote to Repeal Medicare Advisory Board

An important cost-containment feature in the 2010 health care legislation has come under attack in the House, where two committees voted last week to do away with the Independent Payment Advisory Board (IPAB) without approving an alternative.

The Concord Coalition has long supported the IPAB mechanism, which was designed to rein in future growth in Medicare spending. The board will consist of 15 independent experts, appointed by the president and confirmed by the Senate. If Medicare spending growth exceeds certain targets, the IPAB will develop recommendations to reduce the per capita rate of growth. Unless Congress acts to overturn these recommendations, they will automatically be put into effect.

The House Energy and Commerce Committee voted to abolish the IPAB last Tuesday, followed later in the week by Ways and Means. Sara Imhof, a health care policy analyst and Midwest field director for The Concord Coalition, calls this “an alarming attempt to undo a key cost-saving enforcement mechanism without putting anything in its place.”

Critics claim the advisory board would usurp congressional authority and result in “rationing.” But if Congress doesn’t like IPAB’s recommendations, it can replace them with its own cost-saving measures. As for “rationing,” that term could be used to describe anything that imposes some limits on health care expenditures.

“Fiscal and health care policy experts agree that controlling the growth of health care spending will be essential to putting the federal debt on a sustainable path,” Imhof wrote in a blog post Monday. “The IPAB is certainly not a panacea. However, it is one tool among many that offers hope for progress toward a more efficient and cost-effective Medicare program.”